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Page 1: Managing High Cholesterol - Metabolicmetabolic.ie/.../2019/08/Managing-your-cholesterol.pdf · 2 title page what is cholesterol 3-5 what causes high cholesterol 6 what is familial

1

Managing HighManaging High

Cholesterol Cholesterol

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TITLE PAGE

WHAT IS CHOLESTEROL 3-5

WHAT CAUSES HIGH CHOLESTEROL 6

WHAT IS FAMILIAL

HYPERCHOLESTROLAEMIA

7

THE DIFFERENT TYPES OF FATS 8-9

TIPS FOR LOWERING CHOLESTEROL 10-15

READING FOOD LABELS 16-20

HEALTHIER ALTERNATIVES—TAKE AWAY

AND EATING OUT

21-23

COMMONLY ASKED QUESTIONS 24-27

COOKING TIPS 28

RECIPES 30-32

Table of contents

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What is Cholesterol?

Cholesterol is a type of fat found in your blood. It is essential for your cells and to produce

important hormones needed by the body. However, excessive cholesterol can build up in the

blood and can stick to your artery wall which is bad for your heart and blood vessels if not

managed correctly. Once any cholesterol has lined your arteries, you cannot remove it, but you

can stop it from getting worse.

Checking cholesterol

Total cholesterol is made up of different types of cholesterol, low density lipoproteins (LDL) and

high density lipoproteins (HDL). LDL is often referred to as the bad cholesterol as it carries

cholesterol to your surrounding arteries and veins. High density lipoproteins (HDL) which is

referred to as good cholesterol as it takes cholesterol from the blood to be broken down in the

liver. You can check your cholesterol by getting a simple blood test.

High Density Lipoprotein (HDL) Low density Lipoprotein (LDL)

High levels of HDL protect against heart

disease and stroke

Takes excess cholesterol from the walls of

blood vessels to the liver where it is broken

down

Regular physical activity can help in-

crease your HDL levels

Aim for more than 1 mmol/l

High levels of LDL increase your risk

of heart disease and stroke

Carries cholesterol around the body

and can deposit it in the walls of the

blood vessels

Eating foods high in saturated fats

and being overweight can increase

your LDL levels

Aim for less than 3 mmol/l

Total Cholesterol should be less than: 5mmol/l

Triglycerides should be less than: 1.8 mmol/l

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A good rule of thumb is to aim to keep HDL High and LDL Low. People with high

cholesterol generally have no symptoms and so it is really important to regularly get

your cholesterol checked.

What are triglycerides (TAG)?

They are a type of fat found in the body.

They are different to cholesterol as they provide the body with energy.

Unused calories in the body are converted into triglycerides.

High triglycerides and high LDL increase your risk of heart disease.

Aim to keep triglycerides less than 1.8mmol/l

How do I lower triglycerides?

1. Reduce alcohol consumption

2. Reduce sugar intake

3. Consume oily fish twice per week

When getting your cholesterol checked

it is import to look at the breakdown of

cholesterol and not just total cholesterol

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How to interpret your cholesterol results (example)

Cholesterol Value Target Range Possible Causes /

Total Cholesterol 9.9 mmol/l Less than 5 mmol/l High LDL Cholesterol

HDL Cholesterol 1.4 mmol/l Greater than 1 mmol/l Adequate exercise and oily

fish consumption

LDL Cholesterol 7.3 mmol/l Less than 3 mmol/l Excess saturated/ trans fat

TAG 2.2 mmol/l Less than 1.8mmol/l Excess sugar intake

Changes Implemented

Switched to a polyunsaturated spread such as olive based spread ( LDL)

Replaced cakes and biscuits with healthy snacks ( LDL)

Replaced sugary breakfast cereal with high fibre no sugar cereals (TAG)

Bloods Cholesterol checked 6 months later * See below

Type of Cholesterol Value / Target Range Possible Causes

Total Cholesterol 6.2 mmol/l Less than 5 mmol/l Reduced saturated fat intake

HDL Cholesterol 1.5 mmol/l Greater than 1 mmol/ Exercise and oily fish

LDL Cholesterol 3.9 mmol/l Less than 3 mmol/l Reduced saturated fat intake

TAG 1.7 mmol/l Less than 1.8mmol/l Reduced Sugar intake

Although total and LDL cholesterol are not within target range there is a significant improvement

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What Causes High Cholesterol?

1. Hereditary - having a parent with high cholesterol

(familial hypercholesterolemia)

2. Dietary- having a diet high in saturated and trans fats

3. Obesity- related to diet and lack of exercise

Always remember that making small dietary and lifestyle changes can improve

your cholesterol levels. Try and make realistic changes that can be sustained

over a long period of time. This booklet will give the information and practical advice

on how to improve your cholesterol levels.

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What is Familial Hypercholesterolemia?

It is an inherited genetic disorder that can often run in families. Familial means it runs in

families. You only need to get the abnormal gene from one parent in order to inherit the

disease. Cholesterol is elevated from birth. The body has a reduced ability to remove LDL

cholesterol from the blood resulting in high levels of LDL. High LDL is a known risk factor for

heart disease and increases the risk of narrowing of the arteries from an early age. Familial

hypercholesterolemia is managed primarily through diet and lifestyle changes. This is a life

long condition. However, in some cases medications for example statins may be required.

In the early years there are often no signs or symptoms. With extremely high levels of

cholesterol some people may experience:

Chest pain (angina)

Cholesterol deposits in the eye lids (xanthelasmas)

Fatty skin deposits called xanthomas over parts of the hands, elbows, knees, ankles

and around the cornea of the eye

What are statins?

They are the most common medication used to help lower

cholesterol when dietary and lifestyle changes are not

effective. If you require statins these must be taken in

conjunction with a healthy diet to optimise cholesterol levels.

Your doctor will advise you if you require these.

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The Different Types of Fats

There are lots of different types of fats and it can be confusing to know which ones are good

for us or not. The tables below will help you learn about the different types and how they

affect our cholesterol.

Saturated Fats LDL Trans Fats LDL and HDL

Butter Cakes/ Biscuits Pastries Foods that have ‘hydrogenated oils or fats’ or ‘partially hydrogenised oils or fats’ in the list of ingredients likely contain trans fats

Hard cheese Cream Cakes

Whole milk Lard Biscuits

Fatty meat Dripping Crackers

Meat products Suet Depp fried foods

Stearic Acid Coconut oil Takeaways

Palm oil Pastry Hard margarines

Trans fats

Occur naturally in a small amount of dairy food and some meats. These are considered

safe to eat in small quantities

A process called hydrogenation is used in the manufacturing of changing vegetable oils

into solid fats. This process is not good for our health and as a results trans fats

increase LDL & reduce HDL

Industrially produced trans fats from spreads and cheap cakes/ biscuits have been

linked with an increased risk of cardiovascular disease and are best avoided!

Trans fats are the only fat that reduces HDL and increases LDL.

Currently the nutritional information on food packaging is not obliged to include

information on trans fats.

Foods that contain hydrogenated fats or oils are most likely going to contain trans. This

information is generally on food labels.

Saturated fats

They are usually solid at room temperature. They are mainly found in meat and dairy products.

The table below shows you common foods that contain saturated fats.

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Unsaturated fats

They are usually liquid at room temperature. Some are also found as spreads. It is good to

have a mixture of monounsaturated, polyunsaturated and omega 3 fats in your diet. The table

below shows you common foods that contain unsaturated fats.

Monounsaturated fats

Reduce LDL

Polyunsaturated fats

Reduce LDL

Omega-3 fats

Increase HDL Reduce LDL Reduce triglycerides

Peanut oil, olive oil and rape-seed oil, sesame oil

Corn oil, sunflower oil and soya oil

Fish oil

Avocado Nuts and seeds (walnuts, pine nuts, sesame seeds and sunflower seeds)

Oily fish such as mackerel, trout, pilchards, sardines, salmon, trout and fresh tuna

Nuts and seeds (almonds, cashews, hazelnuts, peanuts and pistachios)

Some spreads made from polyunsaturated fats

Some spreads made from monounsaturated fats

Remember!!!

All fats have similar calorie values, too much of any high energy food can

contribute to weight gain therefore it is important to use all fats sparingly no

matter how heart healthy they are.

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1. Maintain a healthy weight

Being overweight can put more pressure on your heart. Weight

particularly around your abdomen (tummy) has the highest risk as it is linked with having a

higher LDL and lower HDL. If you are overweight, then losing weight, even if it is just a few

pounds can make a big difference.

2. Reduce intake of saturated fat

The most up to date research recommends replacing saturated fat with unsaturated fats. When

choosing foods always check the label to see if a food is high in saturated fat and always eat

them sparingly. Recently, there have been a lot of conflicting information about saturated fats

and whether they negatively impact our cholesterol and are as bad as we once thought. All

leading health organizations have found a definitive link between saturated fat and heart disease

and the recommendation still remains: Reduce saturated fat intake and replace it with mono

and polyunsaturated fatty acids. Research is on-going in this area.

Tips for lowering cholesterol

3. Increase intake of fruit and vegetables

Eating at least 5 portions of fruit and vegetables a day can help reduce your risk of heart

disease. These foods can come from fresh, frozen or tinned sources. Fruit juice should only be

counted as 1 portion of fruit per day. As a general rule it is always better to consume fruit and

vegetables from foods rather than juice. Fruit and vegetables are a source of fibre, vitamins

and minerals found in the skin of the food. If you consume 5 portions of fruit and

vegetables per day you do not require a multivitamin supplement. More is not always

better.

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5. Complex carbohydrate and fibre

Starchy foods such as cereal, bread, beans, pulses, pasta and rice should be included at most

meals particularly wholegrain versions as they contain a source of fibre. Fibre has been shown

to reduce the absorption of cholesterol from the intestine into the body. There are two types of

fibre insoluble and soluble, both are beneficial at reducing cholesterol. The fibre in the skin of

fruit and wholegrain products would be insoluble fibre. The fibre in the flesh of fruit and oats

would be soluble fibre. Oats in particular are an excellent food choice as they are high in fibre

and low in fat. They also contain beta glucans which have been extensively studied and shown

to have cholesterol lowering properties.

4. Increase intake of oily fish

Fish is naturally low in saturated fat and is a good source of protein. Oily fish contains

essential fatty acids known as omega 3 fatty acids. Oily fish is found in fresh tuna (not tinned

tuna), sardines, herring, mackerel, trout and salmon. These foods should be included in the

diet at least twice per week. Try to avoid crumbed/battered/deep fried fish as a source of

omega 3. Smoked varieties contain fewer omegas 3 than fresh, canned or frozen. Oily fish

contains omega 3 fatty acids which are thought to:

Help keep heart beat regular

Reduce the level of triglycerides

Prevent blood clots from forming in the blood

Increase HDL cholesterol

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6. Reduce alcohol intake

Excess alcohol can damage the heart muscle, increase blood pressure and triglycerides.

Excess alcohol on a regular basis can lead to liver damage and weight gain. If you have heart

failure or a weak heart, you should avoid alcohol completely. If you take aspirin daily, you

should avoid or limit alcohol, depending on your doctor's advice. You should not drink alcohol if

you are pregnant.

What is a standard drink?

A small glass of wine Half a pint of beer or lager Pub measure of spirits

Irish recommendations

Men: 17 standards drinks per week

Women: 11 standard drinks per week

It is important that they are spread out over the week and not saved for one

session, and that no more than 5 standard drinks are consumed in one sitting.

CONTAINER SERVING EST NO. STANDARD DRINKS

Naggin of spirits 200 ml 6

Can of beer/lager 500 ml 2

Bottle of wine 750 ml 7.5

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7. Reduce salt intake

A little salt is needed for maintaining water balance, healthy blood pressure and for healthy

muscles and nerves. However, too much salt in your diet will lead to high blood pressure.

Salt acts like a sponge in your body soaking up liquid and retaining fluid. This extra fluid puts

pressure on your heart to pump blood around your body. It is estimated that in Ireland we

consume approximately 166% of the salt that we need per day. Children should have no

more than 4g of salt per day and adults should have a maximum of 6g of salt per day.

Where do we get salt from?

Processed & packet foods & eating out: 65-70%

Home cooking & at the table: 15-20% Naturally in food: 15%

Tips to reduce salt intake

1. Sea salt, rock salt, garlic salt all have the same effect on the body and should be

avoided.

2. Avoid salt alternatives such as potassium salt. They do not help you adapt to a low

salt diet. If you are taking certain blood pressure medication they may not be

appropriate.

3. Avoid adding salt when boiling pasta, rice or vegetables.

4. Use freshly ground black pepper, herbs and spices for flavouring when cooking.

5. Limit the use of stock cubes, gravy granules and ready-made sauces, which are all

high in salt.

6. Choose fresh vegetables and lean meat more often than tinned or processed

varieties e.g. cured hams, bacon and rashers.

7. If choosing tinned products e.g. fish opt for those tinned in fresh water, olive oil or

lower salt varieties and rinse these products with water to remove excess salts.

8. Try and use less jars and packet soups and sauces, try to make at home.

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8. Increase physical activity

Being physically active is one of the most important things you can do to reduce your

cholesterol. The Irish guidelines for physical activity for children recommends at least 60

minutes of exercise daily and for adults 30 minutes of moderate activity daily. Try to build

more physical activity into your lifestyle aiming for at least 30 minutes of moderate intensity

activity on five or more days of the week. This can be broken up into segments of 10-15

minutes. Remember to check first with your doctor if you have heart problems or are new to

exercise. This may include vigorous walking, gardening, football, basketball, skipping, tennis,

dancing, cycling, rugby, swimming, running, hurling/camogie. Remember to always choose

an activity you enjoy as you are more likely to keep it up.

Regular exercise improves

HDL cholesterol

Controls body weight

Controls blood pressure

Reduces stress levels

Improves self esteem

Exercise boots energy

Promotes better sleep

Exercise is fun!!

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9. Plant stanols and sterols

Plant stanols and sterols are natural substances found in some foods such as oats,

barley, almonds, soy bean oil, sesame seeds and some fruit and vegetables. The amount

you get from natural foods is too little to reduce cholesterol. Plant stanols and sterols

work by blocking the amount of cholesterol your body absorbs from the food you

eat. Cholesterol also gets into your digestive tract from your liver and the plant sterols/

stanols help to reduce the amount of this type of cholesterol you re-absorb as well. If

taken in the right amounts they may lower LDL cholesterol by 10-15% when combined

with a healthy diet. Manufacturers have started adding them to foods and are commonly

found in spreads, yogurts and drinks. These products need to be taken consistently in

conjunction with a healthy balanced diet for them to be effective. Just remember that

although these ingredients can help to lower cholesterol, they are not miracle workers -

you will still need to eat healthily to get the best benefit.

Products containing plant stanols and sterols are not recommended

for children under the age of 5 years, breastfeeding or pregnant

women. If your cholesterol levels are normal there is no need to take

foods with added plant stanols/sterols. Your dietitian will advise you if

you need to start taking them.

The recommended amount of plant stanols and sterols is 2g per day to help

lower cholesterol. It is usually achieved by consuming three portions of a

fortified food per day.

2 teaspoons of spread (0.8g) 1 yogurt drink (2g) 1 yogurt (0.8g) 250ml glass of milk (0.8g)

Some brands include Benecol, Flora Pro-Activ, Danocol as well as supermarket own brands.

**Remember** More is not better. Extra spread with or without stanols and sterols means extra calories and is not recommended.

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Reading Food Labels

Reading food labels is an important part of healthy eating. Food labels can be confusing. This

card is designed to help you understand the information on food labels more easily using the

traffic light colour coding system. When comparing products it is best to look at the ingredients

per 100g this way products can be easily compared. There can be big differences in fat

content between similar products so it is worth checking the label to help you find the

healthiest product.. See below for examples of different products .

You are able to order a copy of these food shopping cards for your wallet rom the Irish

heart foundation : www.irishheart.ie

The main thing you need to check on food labels in the

1. Type of fat

2. Amount of fat

3. Amount of saturated fat

4. If it contains any trans fats

High saturated fat is more than 5g of saturated fat per 100g of the food

Low saturated fat is less than 1.5g of saturated fat per 100g of the food

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Product per 100g Fat Saturated

Fat Sugar Salt

2.9g Milk Fat

1.9g

11g

0.1g

0.2g Milk Fat

0.1g

6g

0.2g

8.7g Palm oil & rapeseed oil

3.3g

20g

0.7g

22g Palm oil

13g

30g

0.3g

14g Sunflower oil

1.5g

20g

1.2g

Can you pick the healthiest food?

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Product per 100g Fat Saturated fat Sugar Salt

11g

Palm oil

8g

36 0.6g

17g

Sunflower oil 2.4g 28g 0.8g

15g

Rapeseed oil 1.3g 22g 1.4g

10g

Palm oil 4.6g 41g 0.4g

25g

Palm oil 14g 52g 0.2

Can you pick the healthiest food?

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The importance of label reading

Ingredients: Wheat Flour (Wheat Flour, Calcium,

Iron, Niacin, Thiamin), Vegetable Oil (Rapeseed Oil),

Salt, Sugar, Sugar Beet Fibre

Total Fat: 2.8g /100g

Saturated Fat: 0.4g /100g

Sometimes you think a product is healthy at a glance for example brown bread. However,

when you read food labels this is not always the case. There are often hidden sources of

unhealthy fats in unexpected products. If you become confident at label reading you will be

able to pick the healthiest variety of that food. Below are a few examples of reading food

labels. Don’t forget your food label card when shopping it will help remind you of what you

should be aiming for.

High saturated fat is more than 5g of saturated fat per 100g of the food

Low saturated fat is less than 1.5g of saturated fat per 100g of the food

Ingredients: Flour (Wheat Flour, Calcium, Iron, Niacin, Thiamin), Vegetable Oil (Palm), Salt, Raising Agent (Sodium Bicarbonate), Yeast Total Fat: 13.5g /100g Saturated Fat: 6.2g /100g

Ingredients: Flour (Wheat Flour, Calcium, Iron,

Niacin, Thiamin), Vegetable Oil (Palm), Salt

Total Fat: 7.7g/ 100g

Saturated Fat: 3.3g/ 100g

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Ingredients: Wholemeal Wheat Flour, Water,

Fermented Wheat Flour, Yeast, Salt

Total Fat: 1.7g/100g

Saturated Fat: 0.4g/100g

Ingredients: Flour, Calcium Carbonate, Iron, Niacin,

Thiamin), Water, Vegetable Oils (Palm Oil, Rapeseed Oil),

Humectant, Sugar, Emulsifiers, Salt, Stabilisers Raising

Agents, Preservatives

Total Fat: 7.2g/ 100g

Saturated Fat: 3.1g/ 100g

Ingredients: Wheat Flour , Water, Sugar, Poppy Seed

Yeast, Salt, Soya Flour, Vegetable Oils (Palm, Rapeseed),

Flour Treatment Agents: Calcium Sulphate, Ascorbic Acid

Total Fat: 1.6g/ 100g

Saturated Fat: 0.3g/ 100g

Ingredients: Wheat Flour, Water, Grain Mix, Oatbran,

Toasted Soya, Flaked Wheat, Poppy Seed), Yeast,

Fermented Wheat, Malt Barley Flour, Soya Flour, Salt,

Wheat Gluten, Vegetable Oil, Dextrose, Flour Treatment

Agent, Folic Acid

Total Fat: 1.6g/ 100g

Saturated Fat: 0.3g/ 100g

Remember!!

Crackers are commonly high in saturated fats– try and find a healthier alternative

Pitta breads are lower In fat than wraps because they do not contain palm oil. Always compare brands to find the healthiest option.

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Take Away and Eating Out

When eating out Swap…. For this

Pizza

Deep Pan pizza

Processed meat

Garlic sauce

Extra cheese

Thin based pizza

Vegetable toppings

Tomato salsa

Low fat cheese

Curry house

Korma dishes, Chicken

tikka masala

Deep-fried pakora

Bhaji and samosas

Poppadoms

Naan bread

Tomato based dishes, dry curries

Clay baked meat

Grilled kebabs

Vegetables with tomato salsa

Chapati

Thai restaurant

Deep-fried egg rolls

Spring rolls

Egg Fried Rice

Satay dishes/ Coconut

based curries

Deep-fried egg noodles

Mango and papaya salad

Hot, clear soups with chicken or

prawns

Steamed rice

Vegetable or tomato based curry

Steamed noodles

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When eating out

Swap…. For this

Italian

Pasta carbonara, cream based sauces Breaded meat Cheese-covered crostini Garlic bread

Pasta in tomato (Arrabiata) vegetable, Marinara sauce Grilled/ baked meat or fish in lemon/wine sauce Minestrone soup or bruschetta Mixed salad (dressing on the side) with bread sticks

Deli

Mayonnaise and coleslaw Breaded chicken/ processed meat Large white roll/ Panini Cheddar/ Parmesan/ Brie Crisps

Tomato relish/ hummus Tinned tuna, turkey/chicken breast Wholegrain wrap or bread Low fat cream cheese or cottage cheese

Popcorn

Chinese

Deep fried wontons Prawn crackers Duck with skin/ battered chicken Fried rice or noodles Satay sauce

Hot and sour soups Crispy vegetables Grilled seafood Boiled nice or noodles Yellow or black bean sauce, oyster, ginger, hoisin or plum sauce

Take Away and Eating Out

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When eating out Swap…. For this

Coffee shops

Full fat latte

Full fat mocha

Caramel Macchiato

Hot chocolate with cream

Croissant/ muffin with butter and jam

Skinny latte

Skimmed cappuccino

Plain iced coffee

Low fat hot chocolate with

no cream

Brown toast with low fat

spread and jam

Ice cream parlour

Ice cream

Caramel/ chocolate sauce

Toppings: chocolate, marshmallows,

toffee

Fruit sorbet

Fruit coulis

Toasted almonds, mixed

fruit

Drinks

Large glass of wine Fizzy drinks Juice

Small glass wine Sparkling mineral water with lemon instead /Diet versions Sugar free dilutable squash

Take Away and Eating Out

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Some Commonly Asked Questions

1. Should I include coconut oil in my diet?

Coconut oil is currently popular in the ‘Paleo’ and ‘clean eating’ diet trends. It claims to have a

number of health benefits and is popularly called the latest ‘superfood’. There is currently not

enough evidence to recommend coconut oil over healthy fats such as olive or rapeseed

oil. Making the switch to coconut oil is likely to lead to less favourable fat profiles and potentially

increase the risk of coronary heart disease based on the information we know now.

The facts about coconut oil

Coconut oil is very energy dense. 92% of which is made up of saturated fatty acids

Coconut oil is particularly high in one type of saturated fatty acid called lauric acid

Unlike some other oils, it provides no vitamins or antioxidants compounds like those found

in extra virgin olive oil

It is thought that lauric acid mimics unsaturated fats by increasing HDL and preventing

negative health effects. However, studies show that with the consumption of coconut oil,

healthy HDL cholesterol levels appears to rise but so does total cholesterol and LDL

cholesterol in the blood and overall are not cardio protective. Evidence is not consistent

Based on the latest scientific evidence we do not recommended coconut oil over poly

unsaturated fatty acids such as olive and rapeseed oils

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2. Choosing Butter or Spread?

Butter Monounsaturated &

Polyunsaturated Spreads

Butter contains saturated animal fat

Olive oil and sunflower spreads are examples of

mono and polyunsaturated fats

This type of fat increases your LDL choles-

terol which is a risk factor for heart disease

These types of fat can reduces your LDL or

raise HDL cholesterol

For example butter:

Nutritional information per 100g

Saturated Fat: 53.5g

Polyunsaturated: 2.7g

Monounsaturated:19.4g

For example olive spread:

Nutritional information per 100g

Saturated Fat: 10.5g

Polyunsaturated:9.5g

Monounsaturated: 22.4g

The verdict?

For people with high cholesterol it is best to swap saturated fat for a mono or

polyunsaturated fat e.g. olive oil or sunflower spread.

Always remember to check individual food labels as there is a huge variety of spreads

available. Most supermarket brands of spreads have improved their manufacturing and

are trans fat free. However, it is always a good idea to double check the label

particularly with low cost spreads.

Therefore most heart healthy spreads are better for people with high cholesterol.

Whatever spread or oil you decided to use try to use it as sparingly as possible.

See pages 8/9 for the breakdown of the different fats. Too much of any fat in the diet is

not beneficial, particularly if you have high cholesterol.

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5. Is chocolate good for me?

Chocolate is a source of antioxidants called polyphenols. Fat in chocolate comes from

cocoa butter which is made up of a mix of oleic acid, steric acid and palmitic acid which is a

combination of monounsaturated and polyunsaturated fats. It is thought that stearic acid

may have a neutral effect on blood cholesterol neither lowering or increasing it. However,

the type of chocolate you choose is very important. The darker the chocolate the greater the

health benefits. White chocolate is extremely high in sugar. There is currently no established

serving size that is thought to be cardio protective so the recommendation remains the

same saying that chocolate should only be consumed in moderation and try to choose

a chocolate with a cocoa content of greater than 70%.

Despite the potential cardiac benefits all types of chocolate are high in calories and is not

good if you are concerned about your weight.

3. Should I be juicing?

The simply answer is NO! Juicing has recently become a very popular trend. People

have started going on juice ‘detox’ where no food is consumed for a number of days

and the diet is based solely on juice. Celebrities are regularly commenting about the

health benefits of juicing. They claim that juicing helps flush toxins from your body lead-

ing to more energy and weight loss, promising amazing results in a limited amount of

time. However, when it comes down to the scientific evidence, detox diets fall short and

could potentially cause more harm than good.

The facts

Fruit contains soluble and insoluble fibre. Insoluble fibre is found in the skin of fruit

and soluble fibre (invisible fibre) is found in the flesh of the fruit.

All of the fibre has been removed from juices and so blood sugars increase rapidly

It is always better to choose whole fruit versus juices

Your liver is designed to eliminate toxins from the body not juices

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4. What about red wine?

Antioxidants in red wine called polyphenols may help protect the lining

of blood vessels in your heart. The general consensus is that red wine

is thought to improve your heart health if taken in moderation. There

is not enough evidence to recommend that you start drinking

alcohol just to prevent heart disease. However, if you enjoy the

occasional glass of red wine it is ok to continue with it. Any alcohol

taken in excess will negatively effect your heart health.

6. Is there such thing as super foods?

The simple answer is NO. It is important to remember that we need to look at the whole diet for

the prevention of disease. Our body’s require a range of different nutrients for optimal health.

Our diets should vary of whole foods, fruits, vegetables, legumes, grain-based foods, nuts, lean

meats, fish and reduced-fat dairy, rather than focusing on a select set of so called ‘super foods’

to boost our health. Remember, no one food provides all the nutrients we need. The best way to

ensure you are getting all the nutrients you need is to consume a variety of foods and aim for 5

portions of fruit and vegetables per day.

7. Can I still eat eggs?

Eggs contain cholesterol but they have little effect on your blood

cholesterol

Recent research confirm that ‘an egg a day is ok’

There is no cholesterol in the egg whites. The egg yolk does

contain cholesterol but also nutrients including vitamin A, B12. D,

iron and folate

The best way to cook an egg is either poached or boiled. What accompanies the egg

often has a greater effect on cholesterol rather than the egg itself. For example fried

eggs, hollandaise sauce and butter

Cholesterol is made by our liver but some foods contain cholesterol such as eggs, shellfish

and liver. Evidence shows that cholesterol found in food has little or no effect on blood

cholesterol. These foods can still be eaten in moderation as part as a healthy diet.

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Cooking Tips

Use a rack to drain off fat when you broil, roast or bake

Don’t cover foods with drippings; use wine, vinegar or fruit juice

instead

Use lemon, yogurt or fruit based marinades instead of oil based marinades

Broil or grill foods instead of pan-frying

Cut off all visible fat from meat before cooking, and take all the skin off poultry pieces.

(If you’re roasting a whole chicken or turkey, remove the skin after cooking.)

Use a vegetable oil spray to brown or sauté foods

Serve smaller portions of higher-fat dishes, and serve bigger portions of lower-fat

dishes like pasta, rice, beans and vegetables

Instead of regular cheese, use low-fat, cottage cheese and other fat-free or low-fat,

cheeses (generally the harder the cheese the higher the fat content e.g. Cheddar and

parmesan cheese).

Useful Tips for Eating Out

It is easier to control your fat intake at home but eating out is

something that can still be enjoyed when trying to lower your cholesterol

Takeaways are generally extremely high in fat and salt and should only be eaten occa-

sionally or for special occasions

Always plan ahead if eating out and consume low fat foods at every other meal during

that day

Ask for vegetables/ salads to be served without sauces or butter or for sauces to be

served on the side. This way you have control over your portions

Choose dishes that have been grilled, baked or steamed instead of deep fat fried

Choose dishes that are based on a tomato sauce rather than cream based sauces

Foods that contain pastry, cheese, large amounts of meat and cream are generally

high in saturated fat and are best avoided

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Quick and Easy Pizza Wrap , Serves 1

Ingredients Method

1 Wholegrain wrap

1 table spoon of tomato puree

2 sliced tomatoes

1 teaspoon of mixed herbs (or fresh)

Low fat cheddar cheese grated

Variety of toppings i.e. olives, sweet

corn, peppers, mushrooms, onions and

pineapple and rocket

1. Spread the tomato puree, herbs and sliced

tomato on the wrap.

2. Add a variety of toppings onto your pizza.

3. Finish with some grated cheese.

4. Bake in a pre heated oven at 180 degrees for

15 minutes or until golden and bubbly.

Recipes

Ingredients Method

250g Dried Apricots (quartered)

200ml Freshly Squeezed Orange

Juice

4 tsp Honey

150ml Low fat Natural or Greek Yo-

gurt

15 g Shelled Pistachio nuts (roughly

chopped)

1. Place the apricots in a small saucepan with the

orange juice and 2 tsp of honey.

2. Simmer for about 10 minutes or until soft and

plump , allow to cool.

3. Divide the fruit between 4 glasses, then add the

yogurt, spooning it over the fruit before drizzling

each serving with 1 teaspoon of honey and scatter-

ing over with Pistachio nuts .

Fruity Apricot Dessert Serves 4

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Recipes

Ingredients Method

1 Large Potato

Olive oil

Small tin of drained tuna

1 tbsp low fat natural yogurt

1 tsp mustard

Squeeze of Lemon Juice

1/2 apple, grated

1 gherkin sliced (optional)

Black pepper

Side salad

1. Wash the potato, Pierce with a fork several times.

2. Rub with a little bit of olive oil .

3. Bake in a pre heated oven at 200 degrees for 1 hour.

4. Make the tuna mix by mixing the remaining ingredi-

ents.

5. Serve the baked potato with a side salad .

6. You can fill the potato with your own choice of

healthy fillings.

Baked Potato with tuna surprise, Serves 1

Zingy Yogurt Dip, Serves 4

Ingredients Method

50g Extra light mayonnaise

100g Low fat natural or Greek yogurt

Handful of fresh coriander leaves

A squeeze of Fresh Lemon juice

1- 2 teaspoons of curry powder

Black pepper

Combine all of the ingredients in a bowl

Serve with:

- Carrot, Pepper, Celery stick

- Baked sweet potato wedges

-Whole grain pitta bread

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Recipes

Sesame Crusted Salmon with rosemary potato wedges, Serves 4

Ingredients Method

For the salmon

4 salmon fillets

Lemon cut into 4 wedges

Fresh or dried herbs e.g. coriander /

parsley/ basil

Black Pepper

For Potato Wedges:

4 Potatoes

Sprinkle of Olive oil

4 sprigs Fresh rosemary

4 cloves of garlic

Black pepper

For the salmon:

1. Squeeze and place a wedge of lemon on

each salmon fillet .

2. Sprinkle with fresh or dried herbs of your

choice .

3. Season with black pepper.

4. Wrap and seal in tin foil.

5. Place on baking tray and cook in a preheat-

ed oven at 180 degrees for 20 minutes.

For Potato Wedges:

1. Wash potato. Cut into wedges (leave skin

on).

2. Sprinkle with olive oil, rosemary, garlic and

pepper.

3. Cook in a preheated oven at 180 degrees

for 40 minutes (depends on size of wedg-

es).

4. Serve salmon and wedges with lemon, se-

lection of vegetables and some dip.

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Ingredients Method

1 onion

2 garlic cloves

1 teaspoon rapeseed oil

1 carrot, chopped

1 red pepper, chopped

1 red chilli pepper, chopped (optional)

1 celery stick, chopped

500ml chicken or vegetable stock

400g can of chopped tomatoes

1 tsp tomato puree

1 tin of chickpeas

Fresh coriander or other fresh herbs

1 tbsp of balsamic vinegar

Season with black pepper

1.Place the oil in a pot and add in the onion

and garlic and sauté for 10 minutes until soft.

2. Add the carrots, peppers, chilli, celery,

stock, tomatoes, balsamic vinegar and tomato

puree.

3. Cook for 15 – 20 minutes or until the vegeta-

bles are just cooked.

4. Add the chickpeas and cook for a further 5

minutes.

5. Add fresh herbs and serve hot.

6. Add a dollop of low fat natural yogurt, fresh

yogurt coriander and serve with brown bread.

Minestrone soup, Serves 6

Recipes

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Disclaimer: Where specific brands are shown or mentioned these are

for illustrative purposes only. We do not endorse any particular

products.

Note: The information in this booklet is correct at the time of writing

and the recommendations made are based on the most up to date

scientific evidence at the time of printing so we recommend you use

this only under full dietary and medical supervision.

Acknowledgements: We would like to acknowledge the Irish heart

foundation for their contribution to this booklet.

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The National Centre for Inherited Metabolic Disorders

The Children’s University Hospital

Temple St

Dublin 1

01 878 4317

Email: [email protected]

Updated March 2016